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Necessary Meds

I am definitely not what you would call an earth mama, tree hugger, nature girl, or any other designation that implies all natural, holistic, believer in naturopathic methods in lieu of modern medicine.

However, I do make an honest attempt to eat well, take my vitamins (just in case) and get a moderate amount of exercise providing the weather is decent enough to not require a full-length down coat and insulated boots.

Also, I am not quick to pop pills. If meds (like antibiotics that we are fortunate enough to have access to) are necessary because nothing else will do the trick, then I will be the first one in line at the pharmacy counter. This applies to my kids’ welfare, as well. If they are sick and the appropriate OTC remedy or prescription can help, then I am all for it. Everything in moderation.

Where am I going with this? Though I am generally not a supporter of longer term use of meds, there are exceptions. Much written these days about the ADHD over-diagnosis. Too many kids are on Ritalin or Adderall or some other flavor of the day. Do we know the effects of long-term stimulant meds? I’d rather see alternate strategies employed that can provide relief for the child with too much energy, not enough focus and poor organization skills, especially in really young children. Sometimes, the meds are the only thing that does the trick. We held off for several years until our pediatrician said, “You’ll know if you are doing the right thing. Olivia’s behavior will be like night and day.” She was right.

Six years later, at age 14, when Olivia confided in me that she was transgender and really was a boy trapped in a girl’s body, she immediately followed the confession by a pronouncement that she “couldn’t wait to start on “T.”

“T” is trans-speak for Testosterone.

I wanted to scream, “You are too young. You don’t know what you want. You have no idea what the side effects are. This is irreversible. There are cancer risks. Why would you want to grow facial hair? We need to talk about this? Maybe you can consider this when you are eighteen…not before.”

But I didn’t.

Calmly, I outlined my concerns. Apparently, Hunter had already done a lot of research. He understood that in order to even be considered for hormone therapy, one needed to undergo a certain amount of psychotherapy by a qualified professional. He also was unfazed by my concerns. In his mind this was not a passing phase, a decision made on the fly or the “want” of the day. He had been thinking about this for a very long time.

Now you know how I feel about unnecessary meds. Was testosterone really necessary? I was just getting used to the short hair and shopping in the boys’ department. We hadn’t even begun the talk about using male pronouns. Really? Hormone therapy? I needed to process this.

So, here we are, one year later and we have come to understand, thanks to leading Pediatric Endocrinologist, Dr. Norm Spack, that if Hunter doesn’t start “T” while in high school, he will go to college “looking like a fourteen year old boy.” What a way to not fit in.

I am coming to terms with the idea that this is one prescription that falls into the “necessary” bucket.

7 thoughts on “Necessary Meds”

You really are navigating a whole new world, and you’re doing a marvelous job! Your compassion, unconditional love and support, and willingness to consider things that were previously unimaginable illustrate what an inspirational person, advocate, and parent you are.

Look into the effects of low-dose testosterone. First off, as much as Hunter may want to take higher doses thinking the effects will kick in sooner, don’t! If he takes too much…the body will convert it into estrogen. Quite the irony, no? And given how young he is, make sure he is on estrogen blockers if he isn’t already. Though you may hear side effects like increased aggression and such, well, Matt Kailey (RIP, http://tranifesto.com/testosterone-faq/) and Hudson (http://www.ftmguide.org/myths.html) here have good FAQs and a few myth busters, respectively, on the effects of T.

Their site also has good information on surgery if Hudson ever wants to go that far, but http://www.femaletomale.org/ftm-transitioning-guide/testosterone-hrt/ also has tons of FtM resources and links. Hope this helps him out. If you look at Matt Kailey’s Tranifesto, he also includes plenty of references for the friends and family of people transitioning.

Testosterone plus the estrogen blockers will prevent his body from developing into something gynecological, like most women, but rather into something more andrological, which is how he may see himself. This will help Hunter’s body align more with how he sees, and wants to see himself. It will save him on surgery, in costs and health, later on in life. I see taking the T not as a form of long term medicine someone with ADD or depression takes, but a pill someone with high blood pressure, diabetes, or even HIV, would take. See his transition not as something psychological, but as something physical. Could that help?

Due to insurance rules, most trans* people are treated for a “hormone imbalance” which is probably closer to the truth then anything else.

Along that same line of reasoning, you wouldn’t deny a diabetic their insulin (also a hormone) since it is necessary for life. Trans* people on the biochemical level do not produce sufficient levels of the hormones specific to their gender (identity), in that case it’s entirely medically appropriate and necessary to supplement those hormones.

Tristen,
I can’t speak from the science lens; I am a parent so I am writing more from the emotional view. However, I do agree that if this is what a transgender person needs to feel whole then it should be considered carefully, accessible and monitored.

I’m not clear on the science behind excess hormones being converted to their opposite analogues (the same is said about taking excess estrogen). Most substances in “excess” in the body are simply excreted.

If there is any science to it, feedback loops may cause the opposite hormone to increase though in the short term to compensate for the higher levels. But through those same loops, excess levels eventually cause the body to decrease production of the hormone in question.